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      "text": "These results are strange because the increase in histamine levels in the brain should be immediate and so the therapeutic effect should also be rapid (and should not require 6 months to reach a maximum effect).",
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      "text": "Excessive daytime sleepiness (EDS) score per ESS in HARMONY 3",
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      "text": "In the 12-month HARMONY 3 open-label clinical trial, the maximal effect isn’t reached until 6-9 months of daily administration – for both de novo patients (9 months) and those already exposed to the drug (6 months).",
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      "text": "These results are strange because the increase in histamine levels in the brain should be immediate and so the therapeutic effect should also be rapid (and should not require 6 months to reach a maximum effect).",
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      "text": "“These results are strange because the increase in histamine levels in the brain should be immediate and so the therapeutic effect should also be rapid (and should not require 6 months to reach a maximum effect). If one takes an antihistamine (H1 blocker) such as Benadryl, the somnolent effect occurs at peak plasma levels – approximately 30 minutes later. One does not need to take them for 3 months to achieve this.” — Pharmacology consultant",
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      "text": "We further note that the time to maximal effect on the EDS endpoint (excessive daytime sleepiness) undermines pitolisant’s supposed mechanism of action",
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